The liver is a marvelously sophisticated chemical laboratory, capable of
carrying out thousands of chemical transformations on which the body depends.
The liver produces some important chemicals from scratch and modifies others to
allow the body to use them better. In addition, the liver neutralizes an
enormous range of toxins. Without a functioning liver, you cannot live for
long.

Unfortunately, a number of influences can severely damage
the liver, of which alcohol is the most common. This powerful liver toxin harms
the liver in three stages: alcoholic fatty liver, alcoholic hepatitis, then cirrhosis.
Although the first two stages of injury are usually reversible, cirrhosis is
not. Generally, liver cirrhosis is a result of more than 10 years of heavy
alcohol abuse.

Usually, alcoholic hepatitis is discovered through
blood tests that detect levels of enzymes released from the liver. The blood
levels of these enzymes—known by acronyms such as SGOT, SGPT, ALT, AST, and
GGT—rise as damage to the liver (by any cause) progresses.

If
blood tests show that you have alcoholic hepatitis (or any other form of liver
disease), it is essential that you stop drinking. There is little in the way of
specific treatment beyond this.

Principle Proposed Natural Treatments

Several herbs and supplements have shown promise
for protecting the liver from alcohol-induced damage. However, none of these
has been conclusively proven effective, and cutting down (or eliminating)
alcohol consumption is undoubtedly more effective than any other treatment. For
information regarding natural treatments that can help people stop drinking,
see the article on
alcoholism
. The alcoholism article also discusses the
depletion of certain nutrients, which may affect people who consume enough
alcohol to damage the liver.

Below, we concentrate on treatments
used specifically to treat early liver damage caused by alcohol. Treatments for
more advanced alcohol-induced liver damage are discussed in the
liver
cirrhosis
article.

Milk
Thistle

Numerous
double-blind,
placebo-controlled studies
enrolling a total of several hundred
people have evaluated whether the herb
milk thistle
can successfully counter alcohol-induced liver damage. However, these studies
have yielded inconsistent results.
For example, a double-blind,
placebo-controlled study performed in 1981 followed 106 Finnish soldiers with
alcoholic liver disease over a period of 4 weeks.
1
The treated group showed a significant decrease in
elevated liver enzymes and improvement in liver structure as evaluated by
biopsy in 29 subjects.

Two similar studies enrolling a total of
approximately 60 people also found benefits.
2,3
However, a 3-month, double-blind, placebo-controlled study of 116 people showed
little to no additional benefit, perhaps because most participants reduced
their alcohol consumption and almost half of them stopped drinking
entirely.
4
Another study found no benefit in 72
patients who were followed for 15 months.
5

A 2007 review of published and unpublished studies on milk thistle as a treatment for liver disease concluded that benefits were seen only in low-quality trials, and, even in those, milk thistle did not show more than a slight benefit.
17
A subsequent 2008 review of 19 randomized trials drew a similar conclusion for alcoholic liver disease generally, although it did find a modest reduction in mortality for patients with severe
liver cirrhosis
.
18

For
more information, including dosage and safety issues, see the full
Milk Thistle
article.

Other Proposed Natural Treatments

The supplement
SAMe
has also
shown some promise for preventing or treating alcoholic hepatitis, but as yet
there is no reliable evidence to support its use for this purpose.
6-9

The supplement
TMG
helps the
body create its own SAMe and has also shown promise in very preliminary
studies.
10-13

Herbs and Supplements to Avoid

High doses of the supplements beta-carotene and
vitamin A might cause alcoholic liver disease to develop more rapidly in people
who abuse alcohol.
14,15
Nutritional
supplementation at the standard daily requirement level should not cause a
problem. See the articles on
Vitamin A
and
Beta-carotene
for more information.

Although one animal study suggests that the
herb
kava
might aid in alcohol withdrawal,
16
the herb
can cause liver damage; therefore, it should not be used by people with
alcoholic liver disease (and probably not by anyone at all). Numerous other
herbs possess known or suspected liver-toxic properties, including coltsfoot,
comfrey, germander, greater celandine,
kombucha
, pennyroyal, and various prepackaged
Chinese herbal
remedies
. For this reason, people with alcoholic liver disease
should use caution before taking any medicinal herbs.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.